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      APLICABILIDAD DE SIMULADORES DE MEDIANA COMPLEJIDAD EN EL PROCESO DE FORMACIÓN DE RESIDENTES DE GINECOLOGÍA Y OBSTETRICIA

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          Abstract

          Antecedentes: El entrenamiento de técnicas quirúrgicas durante la formación de gineco-obstetras encuentra dificultades por razones de seguridad de la paciente y del recién nacido. Una de las estrategias utilizadas es el uso de simuladores para facilitar la adquisición de las habilidades necesarias para resolver situaciones críticas frecuentes en la práctica médica, salvaguardando la ética en la enseñanza y mejorando su calidad. Objetivos: Evaluar el uso de simuladores de parto interactivo de mediana complejidad (Noelle® Gaumard Scientific, Miami, FL) como método de educación médica para adquirir las destrezas necesarias en la atención de un parto operatorio con Espátulas de Thierry. Método: Diseño: estudio piloto prospectivo controlado. Sujetos: seis médicos en formación de la especialidad de la Universidad de los Andes. Se definieron aleatoriamente 2 grupos estratificados por año de formación. A todos se les instruyó en sesión teórica sobre el uso de las espátulas. La mitad tuvo una sesión práctica. Se utilizó un simulador y pautas estandarizadas para evaluar la adquisición de habilidades. Resultados: Se expresó según el porcentaje del puntaje máximo logrado para cada prueba. El grupo experimental tuvo un resultado en la evaluación práctica de 90/25/90%. El grupo control 35/70/65%. Se observó menos diferencias inter grupos en la prueba teórica. Conclusión: Las habilidades asociadas al uso de las espátulas de Thierry se adquirieron más completamente en el grupo expuesto a un taller con simuladores de mediana complejidad.

          Translated abstract

          Background: The training on surgical techniques during the instruction of obstetrician-gynecologists finds some difficulties because of patient and newborn's safety concern. One of the strategies is to use simulators that facilitate the acquisition of the skills required to solve critical situations, common in medical practice. Objective: To evaluate the use of simulators (Noelle™ Gaumard Scientific, Miami, FL) in medical education as a mean to acquire the skills needed for an instrumental delivery using Thierry's spatulas. Methods: Design: prospective controlled pilot study. Participants: six medical residents of obstetrics and gynecology from Los Andes University. They were randomized on two groups stratified by years of resideney. All of them received a lecture on Thierry's spatulas. Half of them also had a workshop. A simulator and standardized guidelines were used to evaluate the skills acquisition. Results: They were stated by the percentage of maximum score achieved to each test. The experimental group had a practical score of 90/25/90%. The control group got 35/70/65%. There were few differences in the written test between groups. Conclusion: The experimental group showed a better performance in the use of Thierry's spatulas.

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          To the point: medical education review of the role of simulators in surgical training.

          Simulation-based training (SBT) is becoming widely used in medical education to help residents and medical students develop good technical skills before they practice on real patients. SBT seems ideal because it provides a nonthreatening controlled environment for practice with immediate feedback and can include objective performance assessment. However, various forms of SBT and assessment often are being used with limited evidence-based data to support their validity and reliability. In addition, although SBT with high-tech simulators is more sophisticated and attractive, this is not necessarily superior to SBT with low-tech (and lower cost) simulators. Therefore, understanding the types of surgical simulators and appropriate applications can help to ensure that this teaching and assessment modality is applied most effectively. This article summarizes the key concepts that are needed to use surgical simulators effectively for teaching and assessment.
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            To the point: reviews in medical education--the Objective Structured Clinical Examination.

            This article, the eighth in the To the Point Series prepared by the Association of Professors of Gynecology and Obstetrics Undergraduate Medical Education Committee, discusses the effectiveness of the Objective Structured Clinical Examination (OSCE) for assessment of learners' knowledge, skills, and behaviors. The OSCE has also been used for the appraisal of residents and physicians undergoing licensure examinations; herein we focus on its application to undergraduate medical education. We review evidence for best practices and recommendations on effective use of the OSCE and requirements for and challenges to its implementation, including creative ways to design an OSCE program with a limited budget. We discuss its role in providing formative and summative feedback and describe learner performance on the OSCE as the OSCE relates to subsequent testing, including US Medical Licensing Examination step 1. A representative case with assessment used at the authors' medical schools is included.
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              Clinical impact of epidural anesthesia simulation on short- and long-term learning curve: High- versus low-fidelity model training.

              Epidural anesthesia is a technically challenging regional anesthetic technique that can be difficult to teach to novices. Epidural simulators are now available to allow realistic training within a safe and controlled environment before attempting the procedure on patients. Potentially, this may improve skill acquisition by novice residents. The purpose of this study was to examine the effect of a high-fidelity epidural anesthesia simulator on residents' ability to perform their first labor epidurals and on their learning curve compared with a group having training with a low-fidelity model.
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                Author and article information

                Journal
                rchog
                Revista chilena de obstetricia y ginecología
                Rev. chil. obstet. ginecol.
                Sociedad Chilena de Obstetricia y Ginecología (Santiago, , Chile )
                0048-766X
                0717-7526
                2010
                : 75
                : 6
                : 349-354
                Affiliations
                [03] orgnameUniversidad de los Andes orgdiv1Escuela de Medicina Chile
                [04] orgnameUniversidad Finis Térrea Chile orgdiv1Escuela de Enfermería Chile
                [01] orgnameUniversidad de los Andes orgdiv1Facultad de Medicina orgdiv2Departamento de Ginecología y Obstetricia y Biología de la Reproducción Chile
                [02] orgnameClínica Dávila Chile orgdiv1Departamento de Ginecología y Obstetricia Chile
                Article
                S0717-75262010000600002 S0717-7526(10)07500602
                10.4067/S0717-75262010000600002
                d0f3b9fe-694b-4edd-af00-45fbecabf8c2

                This work is licensed under a Creative Commons Attribution 4.0 International License.

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                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 16, Pages: 6
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                SciELO Chile

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                Trabajos Originales

                fantoma,Thierry's spatulas,espátulas de Thierry,phantom,Medical education,Educación médica

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